Paediatrics

Question 1

Discuss some similarities and differences in consulting with children vs with adults.

Answer 1

• there might be difficulty in understanding questions so patience and repetition
• offer help in answers by giving options
• building a rapport with small talk more important at start
• language used must match level of understanding
• pay attention to safeguarding concerns
• triadic with parents
• using non-patronising language important in both

Question 2

What are some strategies in consulting with children?

Answer 2

• importance of body language and non-verbal cues to judge anxiety, shyness etc
• considering child safe environment with toys, sharps away etc
• gentle approach to examination
• praise, role plays, keeping them close to parents but encouraging involvement
• with adolescents be non judgemental and open and allow option of consulting without parent if comfortable.

Question 3

What does a neonatal screen comprise of?

Answer 3

• thorough physical examination to check eyes, heart, hips and testicles
• hearing screen: play sound and check response
• heel prick test: blood sample to check for 9 conditions.

Question 4

What do the neonatal screenings aim to exclude?

Answer 4

• eyes: movement abnormalities, cataracts.
• heart: pulses, murmurs (common and usually normal) for congenital disease
• hips: developmental dysplasia (DDH)
  -testicles: check descend as may cause infertility later on
• hearing: exclude hearing loss
• heel prick: mothers HIV, haemochromatosis, sickle cell, cystic fibrosis, congenital hypothyroidism, metabolic like PKU, SCID

Question 5

What inter-professional team members are involved in the care of pre-school children?

Answer 5

• GP
• Paediatrician
• psychologists
• ## Nurses eg: dietician

Question 6

Why is it harder to spot an unwell child?

Answer 6

• non specific symptoms: abd pain, fever
• subtle signs
• non-verbal and poor at explaining from parent needed
• differing physiology and ability to compensate by body